scholarly journals Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: an air ambulance perspective

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Peter Hilbert-Carius ◽  
Jörg Braun ◽  
Fikri Abu-Zidan ◽  
Jörn Adler ◽  
Jürgen Knapp ◽  
...  
Keyword(s):  
Healthcare Systems ◽  
Air Transport ◽  
Safety Measures ◽  
Air Ambulance ◽  
Medical Interventions ◽  
Related Data ◽  
Naca Score ◽  
Mode Of Transport ◽  
Interfacility Transport ◽  
Transport Potential

Abstract Background COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularly helicopter services—caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients. Methods Nine different HEMS providers in seven different countries across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers in six countries agreed and reported their data regarding development of special procedures and safety instructions in preparation for the COVID-19 pandemic. Four providers agreed to provide mission related data. Three hundred eighty-five COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions. Results All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 4 (2-5) compared with 3 (1-7), needed significantly more medical interventions, were significantly younger (59.6 ± 16 vs 65 ± 21 years), and were significantly more often male (73% vs 60.5%). Conclusions All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.

scholarly journals Pre-hospital care & interfacility transport of 385 COVID-19 emergency patients: An air ambulance perspective.

2020 ◽  
Author(s):  
P. Hilbert-Carius ◽  
Jörg Braun ◽  
Fikri Abu-Zidan ◽  
Jörn Adler ◽  
Jürgen Knapp ◽  
...  
Keyword(s):  
Healthcare Systems ◽  
Air Transport ◽  
Safety Measures ◽  
Air Ambulance ◽  
Medical Interventions ◽  
Naca Score ◽  
Mode Of Transport ◽  
Interfacility Transport ◽  
Safe Care ◽  
Transport Potential

Abstract Background: COVID-19, the pandemic caused by the severe acute respiratory syndrome coronavirus-2, is challenging healthcare systems worldwide. Little is known about problems faced by emergency medical services—particularly helicopter services—caring for suspected or confirmed COVID-19 patients. We aimed to describe the issues faced by air ambulance services in Europe as they transport potential COVID-19 patients.Methods: Nine different HEMS providers across Europe were invited to share their experiences and to report their data regarding the care, transport, and safety measures in suspected or confirmed COVID-19 missions. Six air ambulance providers agreed and reported their data. 385 COVID-19-related missions were analysed, including 119 primary transport missions and 266 interfacility transport missions.Results: All providers had developed special procedures and safety instructions in preparation for COVID-19. Ground transport was the preferred mode of transport in primary missions, whereas air transport was preferred for interfacility transport. In some countries the transport of COVID-19 patients by regular air ambulance services was avoided. Patients in interfacility transport missions had a significantly higher median (range) NACA Score 3 (1-7) compared with 4 (2-5), needed significantly more medical interventions, were significantly younger (59.6±16 vs 65±21 years), and were significantly more often male (73% vs 60.5%). Conclusions: All participating air ambulance providers were prepared for COVID-19. Safe care and transport of suspected or confirmed COVID-19 patients is achievable. Most patients on primary missions were transported by ground. These patients were less sick than interfacility transport patients, for whom air transport was the preferred method.

scholarly journals Adaptation of the AACN Synergy Model for Patient Care to Critical Care Transport

2014 ◽  
Vol 34 (1) ◽  
pp. 16-28 ◽  
Author(s):  
Scott Swickard ◽  
Wendy Swickard ◽  
Andrew Reimer ◽  
Deborah Lindell ◽  
Chris Winkelman
Keyword(s):  
Critical Care ◽  
Patient Care ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Level Of Care ◽  
Patient Centered ◽  
Levels Of Care ◽  
Interhospital Transfer ◽  
Mode Of Transport ◽  
Interfacility Transport

Today’s health care delivery system relies heavily on interhospital transfer of patients who require higher levels of care. Although numerous tools and algorithms have been used for the prehospital determination of mode of transport, no tool for the transfer of patients between hospitals has been widely accepted. Typically, the interfacility transport decision is left to the discretion of the referring provider, who may or may not be aware of the level of care provided or the means of transport available. A need exists to determine the appropriate level of care required to meet the needs of patients during transport. The American Association of Critical-Care Nurses (AACN) Synergy Model for Patient Care is a patient-centered model that focuses on optimizing patient care by matching the characteristics of the patient with the competencies of the nurse. This model shows significant promise in providing the theoretical backing to guide the decision on the level of care necessary to complete interfacility transfers safely and effectively. This article describes a new tool inspired by the AACN Synergy Model for Patient Care to determine the appropriate level of care required for interfacility transport.

Identifying causes of delay in interfacility transfer of patients by air ambulance

CJEM ◽  
2020 ◽  
Vol 22 (S2) ◽  
pp. S30-S37
Author(s):  
Alanna Wong ◽  
Aidan McParland ◽  
Brodie Nolan
Keyword(s):  
Free Text ◽  
Transport Time ◽  
Trip Planning ◽  
Air Ambulance ◽  
Common Causes ◽  
Specialized Care ◽  
Total Transport ◽  
Medical Transport ◽  
Interfacility Transport ◽  
Manual Review

ABSTRACTObjectivesPopulation density can limit the level of care that can be provided in local facilities in Ontario, and as such, patients with severe illnesses often require interfacility transfers to access specialized care. This study aimed to identify causes of delay in interfacility transport by air ambulance in Ontario.MethodsCauses of delay were identified by manual review of electronic patient care records (ePCRs). All emergent interfacility transfers conducted by Ornge, the sole provider of air-based medical transport in Ontario, between January 1, 2016 and December 31, 2016 were included. The ePCRs were reviewed if they met one or more of the following: (1) contained a standardized delay code; (2) contained free text including “delay”, “wait”, or “duty-out”; (3) were above the 75th percentile in total transport time; or (4) were above the 90th percentile in time to bedside, time at the sending hospital, or time to receiving facility.ResultsOur search strategy identified 1,220 ePCRs for manual review, which identified a total of 872 delays. Common delays cited included aircraft refueling (234 delays), waiting for land emergency medical service (EMS) escort (146), and staffing- or dispatch-related issues (124). Other delays included weather/environmental hazards (43); mechanical issues (36); and procedures, imaging, or stabilization (80).ConclusionsSome common causes of interfacility delay are potentially modifiable: better trip planning around refueling and improved coordination with local EMS, could reduce delays experienced during interfacility trips. To better understand causes of delay, we would benefit from improved documentation and record availability which limited the results in this study.

scholarly journals Incidence and Challenges of Helicopter Emergency Medical Service (HEMS) Rescue Missions with Helicopter Hoist Operations: Analysis of 12,000 Daytime and Nighttime Missions in Switzerland

2021 ◽  
Author(s):  
Urs Pietsch ◽  
Jürgen Knapp ◽  
Michael Mann ◽  
Lorenz Meuli ◽  
Volker Lischke ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Severely Injured ◽  
Intravenous Access ◽  
Medical Interventions ◽  
Naca Score ◽  
Peripheral Intravenous Access ◽  
Time Critical

Abstract ObjectiveWe aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.MethodsWe designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) from 1 January 2010 to 31 December 2019.ResultsDuring the study period, 9,963 (88.7%) HEMS missions with HHO and HEC were conducted during the day, and 1,265 (11.3%) at night. Of the victims with time-critical injuries (NACA ≥4), 21.1% (n=400) reached the hospital within 60 min during the day, and 9.1% (n=18) at night. Nighttime missions, a trauma diagnosis, intubation on-site, and NACA Score ≥4were independently and highly significantly associated with longer mission times (p<0.001). The greatest proportion of patients, who needed hoist or HEC operations in the course of the HEMS mission during daytime, sustained moderate injuries (NACA 3, n=3,731, 37.5%) while practicing recreational activities (n=5,492, 55.1%). In daytime HHO missions, the most common medical interventions performed were an insertion of a peripheral intravenous access (n=3,857, 38.7%) and administration of analgesia (n=3,121, 31.3%). ConclusionsNearly 20% of patients, who needed to be evacuated by a hoist, were severely injured, and complex and lifesaving medical interventions were necessary before the HHO procedure. Therefore, only adequately trained and experienced medical crew members should accompany HHO missions.

scholarly journals A study on status of neonatal transport to a level III neonatal intensive care unit

2018 ◽  
Vol 5 (3) ◽  
pp. 1040
Author(s):  
P. Sampathkumar Sampathkumar ◽  
S. Gobinathan
Keyword(s):  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Cross Sectional Study ◽  
Current Status ◽  
Delivery Mode ◽  
Low Oxygen ◽  
Cross Sectional ◽  
Neonatal Transport ◽  
Mode Of Transport ◽  
Interfacility Transport

Background: In the past decade, great advancements in Neonatal care contributed to a fall in IMR. A further fall in IMR can only be achieved by improving the neonatal transport facilities. Hence to assess the current status of neonatal transport we undertook this study.Methods: This is a cross-sectional study of 75 neonates transported to our NICU. For all the babies, data regarding the place of birth, mode of delivery, mode of transport, etc. were collected. On admission parameters like blood glucose, temperature, CRT, SPO2, the presence of cyanosis, shock was assessed.Results: In the present study 64% of neonates came to our NICU on their conveyance. 67% of referrals from PHCs did not utilize ambulance facility. 30% of neonates had hypothermia on arrival. 35%had hypoglycemia on arrival. 15% had a low oxygen saturation on arrival. 15% had prolonged CRT on arrival. Only 8% of neonates received prior treatment. 11% babies did not have any referral slip. Only a very few had complete and proper referral advice.Conclusions: To further reduce the neonatal mortality rate, the neonatal transport facilities should be upgraded. A standard protocol should be formulated for interfacility transport. A separate fleet of neonatal ambulances well equipped and manned by trained personnel is the need of the hour.

Transportation Engineering

Engevista ◽  
2017 ◽  
Vol 19 (5) ◽  
pp. 1284
Author(s):  
Relly Victoria Virgil Petrescu ◽  
Raffaella Aversa ◽  
Antonio Apicella ◽  
Florian Ion Petrescu
Keyword(s):  
Sustainable Management ◽  
Civil Engineering ◽  
Urban Transport ◽  
Air Transport ◽  
Transportation Engineering ◽  
Mode Of Transport ◽  
American Society ◽  
The Cost ◽  
Plan Management

The shipments were absolutely necessary at all times, but still have polluted and damaged the environment. The technique of transport or the engineering of transport is the application of the principles of technology and scientific findings to the planning, design check, operation and plan management for any mode of transport, in order to ensure that the conditions of safety, efficiency, quick, comfortable and convenient, economic and environmentally compatible movement of persons and goods (transport). It is a sub-discipline for civil engineering. The importance of the transport engineering in the framework of the profession of civil engineering can be evaluated by the number of divisions of the ASCE (American Society of Civil Engineers), which are directly related to the transport. There are six such divisions (Aerospace; Air Transport, motorways, pipes, watercourses, port, of coastal and ocean and urban transport), which represents one third of the total 18 technical divisions of the ASCE (1987). Humanity is struggling between technological tests of deployment of new types of mild transport for the environment and the need to maintain still in the operation the machines already polluting products in large quantity, cheaper, more convenient economically, that customers have already been accustomed. Transport is at the heart of major cross-cutting issues that are inseparable from issues related to the development and sustainable management of the mobility of goods and people. The automotive sector must meet several challenges to reduce the emission of particulate and gaseous pollutants while limiting the increase in the cost of vehicles. The development of "clean" or "sustainable" vehicles requires the integration of innovative technologies to meet all these requirements. Those all problems need to be addressed by the discipline named Transportation (Transport) Engineering, in view of the constantly improving the quality of transport carried out. 

Emerging outbreaks associated with conflict and failing healthcare systems in the Middle East

2018 ◽  
Vol 39 (10) ◽  
pp. 1230-1236 ◽  
Author(s):  
Issam I. Raad ◽  
Anne-Marie Chaftari ◽  
Rita Wilson Dib ◽  
Edward A. Graviss ◽  
Ray Hachem
Keyword(s):  
Infectious Disease ◽  
Middle East ◽  
Global Health ◽  
Cutaneous Leishmaniasis ◽  
Preventive Measures ◽  
Healthcare Systems ◽  
Communicable Diseases ◽  
International Medical ◽  
Medical Interventions ◽  
Disease Epidemics

AbstractThe escalating conflicts in the Middle East have been associated with the rapid collapse of the existing healthcare systems in affected countries. As millions of refugees flee their countries, they become vulnerable and exposed to communicable diseases that easily grow into epidemic crises. Here, we describe infectious disease epidemics that have been associated with conflicts in the Middle East, including cholera, poliomyelitis, measles, cutaneous leishmaniasis, and diphtheria, that call for appropriate preventive measures. Local ongoing wars and failing healthcare systems have resulted in regional and global health threats that warrant international medical interventions.

scholarly journals State of Fragility Fractures Management during the COVID-19 Pandemic

2020 ◽  
Vol 17 (21) ◽  
pp. 7732
Author(s):  
Umberto Tarantino ◽  
Ida Cariati ◽  
Virginia Tancredi ◽  
Donato Casamassima ◽  
Eleonora Piccirilli ◽  
...  
Keyword(s):  
Chronic Condition ◽  
Fragility Fractures ◽  
Healthcare Systems ◽  
Health Concern ◽  
Public Health Concern ◽  
Fracture Care ◽  
Medical Interventions ◽  
Increased Risk ◽  
The World ◽  
Skeletal Integrity

Osteoporosis is a public health concern all over the world. As a chronic condition, it generally requires prolonged medical interventions to limit the risks of further bone loss, impaired skeletal integrity and the onset of fractures. This problem is further complicated by the fact that the abrupt cessation of some therapies may be associated with an increased risk of harm. It is in this context that the COVID-19 pandemic has caused an unprecedented disruption to the provision of healthcare worldwide, exceeding our worst expectations in terms of the number of lives lost and the rapidity at which consolidated economies and healthcare systems are being significantly damaged. In this review, we assessed the challenges and strategies used in the management of osteoporosis and fragility fracture care during the COVID-19 pandemic. We also examined the available evidence and provided clinical recommendations that will require reassessment as the worldwide response to COVID-19 evolves.

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